ANNUAL REPORT OF ELIGIBLE RECIPIENT AGENCIES

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U.S. DEPARTMENT OF AGRICULTURE
FOOD AND NUTRITION ADMINISTRATION

ANNUAL REPORT OF
TEFAP ELIGIBLE
RECIPIENT AGENCIES

FORM APPROVED OMB NO. 0584-0293 Expiration
Date: XX/XX/XXXX
Public reporting burden for this collection of information is estimated to average 1 hour per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Administration,
Office of Research and Analysis (0584-0293), Alexandria, VA 22302. Do not return the completed form to this
address.

1. STATE/TERRITORY:

5. FISCAL YEAR:

2. STATE AGENCY NAME:

6. NOTES:

3. ID NUMBER:

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7

A.

INITIAL

B.

REVISION

7. Name of
Eligible Recipient
Agency (ERA)

8. Is the ERA
operating under
an agreement
with the State
agency or another
ERA? Enter “State
agency” or
“ERA.”

9. Other ERA
name (if
applicable):

10. Street
address of ERA
distribution site
(if applicable)

11. City of ERA
distribution site
(if applicable)

12.
State/Territory of
ERA distribution
site (if applicable)

13. Zip code of
ERA distribution
site (if
applicable)

LINE NO.

LINE NO.

4. TYPE OF SUBMISSION

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7. Is the ERA
operating under
an agreement
with the State
agency or another
ERA? Enter “State
agency” or
“ERA.”

8. Other ERA
name (if
applicable):

9. Street address
of ERA
distribution site
(if applicable)

10. City of ERA
distribution site
(if applicable)

10.
State/Territory of
ERA distribution
site (if applicable)

11. Zip code of
ERA distribution
site (if
applicable)

LINE NO.

LINE NO.
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6. Name of
Eligible Recipient
Agency (ERA)

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7. Is the ERA
operating under
an agreement
with the State
agency or another
ERA? Enter “State
agency” or
“ERA.”

8. Other ERA
name (if
applicable):

9. Street address
of ERA
distribution site
(if applicable)

10. City of ERA
distribution site
(if applicable)

10.
State/Territory of
ERA distribution
site (if applicable)

11. Zip code of
ERA distribution
site (if
applicable)

LINE NO.

LINE NO.
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6. Name of
Eligible Recipient
Agency (ERA)

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7. Is the ERA
operating under
an agreement
with the State
agency or another
ERA? Enter “State
agency” or
“ERA.”

8. Other ERA
name (if
applicable):

9. Street address
of ERA
distribution site
(if applicable)

10. City of ERA
distribution site
(if applicable)

10.
State/Territory of
ERA distribution
site (if applicable)

11. Zip code of
ERA distribution
site (if
applicable)

LINE NO.

LINE NO.
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6. Name of
Eligible Recipient
Agency (ERA)

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FORM FNA-929 INSTRUCTIONS
PURPOSE: The FNA-929 captures the eligible recipient agencies (ERAs) that participate in The Emergency Food Assistance Program (TEFAP) within a State/
Territory. Per program regulations at 7 CFR 251.10(b)(3), TEFAP State agencies are required to submit this report to USDA’s Food and Nutrition Administration on an
annual basis consistent with the deadlines set in the Food Programs Reporting System (FPRS). This report must include all ERAs that hold TEFAP agreements
within the State/Territory, including ERAs that have agreements with the State agency and ERAs that have agreements with another ERA. The report must also
include ERAs that distribute USDA Foods for home consumption and those that distribute USDA Foods in the form of prepared meals.
SUBMISSION: Enter ERAs into this report. If more than 100 eligible recipient agencies are reported, use Addendum A to report the additional agencies.
ITEM:

1. State/Territory – Enter the name of the State or Territory in which the TEFAP State agency is located.
2. State Agency Name – Enter the name of the TEFAP State agency.
3. ID Number – Enter the 7-digit identification (ID) number assigned by FNA. This number identifies the State agency and its
TEFAP grant in the FNA automated reporting system.
4. Type of Submission - Indicate type of submission for year being reported. The initial submission of this report should be such by checking (A). Any subsequent
revisions for the report quarter should be indicated by checking (B).
5. Year of Submission - Enter the fiscal year for which data is reported.
6. Notes – Enter any notes about the data submitted in the report.
7. Name of Eligible Recipient Agency – Enter the name of each eligible recipient agency that holds a TEFAP agreement within the State/Territory.
8. TEFAP Agreement Status – For each eligible recipient agency entered, indicate whether the eligible recipient agency holds a TEFAP agreement with the
State/Territory or with another eligible recipient agency within the State/Territory, by entering “State agency” or “ERA.”
9. Other Eligible Recipient Agency Name – For those eligible recipient agencies that hold agreements with other eligible recipient agencies, enter the name of the
eligible recipient agency with which they hold an agreement. For example:
7. Name of Eligible
Recipient Agency (ERA)

(Example) Falling Leaves
Food Pantry

8. Is the ERA operating
under an agreement with
the State agency or
another ERA? Enter
“State agency” or “ERA.”
(Example) ERA

9. Other ERA name (if
applicable):

10. Street address of ERA
distribution site (if
applicable)

11. City of ERA
distribution site (if
applicable)

12. State/Territory of
ERA distribution site (if
applicable)

13. Zip code of ERA
distribution site (if
applicable)

(Example) Summer Sun
Food Bank

(Example) 47832 Red
Maple Lane

(Example) Tree Town

(Example) VA

(Example) 12820

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10. Street Address of Distribution Site – For each eligible recipient agency, enter the street address of each distribution site at which the public accesses USDA Foods.
If the ERA operates multiple distribution sites, enter each distribution site as an additional row. If the eligible recipient agency does not directly distribute foods to the
public, enter “N/A.” For example:
7. Name of Eligible
Recipient Agency (ERA)

8. Is the ERA operating
under an agreement with
the State agency or
another ERA? Enter
“State agency” or “ERA.”
(Example)
State agency

9. Other ERA name (if
applicable):

10. Street address of ERA
distribution site (if
applicable)

11. City of ERA
distribution site (if
applicable)

12. State/Territory of
ERA distribution site (if
applicable)

13. Zip code of ERA
distribution site (if
applicable)

(Example) N/A

(Example) N/A

(Example) N/A

(Example) N/A

(Example) N/A

(Example) Falling Leaves
Food Pantry

(Example) ERA

(Example) Summer Sun
Food Bank

(Example) 47832 Red
Maple Lane

(Example) Tree Town

(Example) VA

(Example) 12820

(Example) Falling Leaves
Food Pantry - Additional
Distribution Site

(Example) ERA

(Example) Summer Sun
Food Bank

(Example) 843 Oak Circle

(Example) Tree Town

(Example) VA

(Example) 12820

(Example) Summer Sun
Food Bank

11. City of Distribution Site – For each eligible recipient agency, enter the city of the distribution site at which the public accesses USDA Foods. If the ERA operates
multiple distribution sites, enter each distribution site as an additional row. If the eligible recipient agency does not directly distribute foods to the public, enter “N/A.”
See example in #10, above.
12. State/Territory of Distribution Site – For each eligible recipient agency, enter the state/territory of the distribution site at which the public accesses USDA Foods. If
the ERA operates multiple distribution sites, enter each distribution site as an additional row. If the eligible recipient agency does not directly distribute foods to the
public, enter “N/A.” See example in #9, above. See example in #10, above.
13. Zip Code of Distribution Site – For each eligible recipient agency, enter the zip code of each distribution site at which the public accesses USDA Foods. If the ERA
operates multiple distribution sites, enter each distribution site as an additional row. If the eligible recipient agency does not directly distribute foods to the public,
enter “N/A.” See example in #9, above. See example in #10, above.

Page 6

7. Name of
Eligible Recipient
Agency (ERA)

8. Is the ERA
operating under
an agreement
with the State
agency or another
ERA? Enter “State
agency” or
“ERA.”

9. Other ERA
name (if
applicable):

10. Street
address of ERA
distribution site
(if applicable)

11. City of ERA
distribution site
(if applicable)

12.
State/Territory of
ERA distribution
site (if applicable)

13. Zip code of
ERA distribution
site (if
applicable)

LINE NO.

LINE NO.

ADDENDUM A – FNA-929

Page 7